Care Home: Moston Grange Nursing Home

What the care home does well Service users have the opportunity of living in small groups. The four units enable service users to feel like they live in a small home rather that a large establishment. This supports service user who may otherwise become anxious in large groups to be relaxed and make friends more easily. A number of service users have difficult or failing mental health with some having related behaviour conditions which prevent them from living alone within the community. The services provided by the manager and members of staff enable service users to receive support to live at the home for as long as they are able and become part of the local community. Service users are supported by a fairly well established staff team. Members of staff receive support ,supervision training and had personal development programmes in place. This makes sure they receive the training they require to support people with failing metal health conditions. What has improved since the last inspection? Care planning and record keeping has been developed since the last inspection. A good attempt has been made to record the service users needs and requirements and how they should be met . Although systems are still in their infancy, service users have been given more opportunities to make decisions for themselves particularly how support is to be provided, going on holiday and being able to contribute to the continued development of the service. Service users have been provided with more opportunities to engage in social activities both within the home and the community. There is now a planned `large group` activity programme which encourages service users from each unit to meet together regularly for social events. Individual social programmes are also in place to support service users to pursue their own hobbies and interests. A record of all complaints are now held which means processes for receiving, investigating complaints were clearly visible. We have given advice to the manager to record all complaints received on each unit, this will make sure that perceived `minor`` issues are known and that patterns and or failing systems can be quickly identified. The manager has made sure that all suspicions or allegations of abuse are reported appropriately to the Local Authority. This makes sure that independent safeguarding procedures can be implemented as required. Regulation 26 visits are completed as required. As as required at the last inspection the reports of those visits have been provided to us . Because of this we know that the home has self monitoring systems in place to make sure standards are maintained correctly and as required. What the care home could do better: To make sure that prospective service users have the information they need, service users guides should be developed for each unit. This would support the service user to make informed decision their future and about the suitability of the accommodation and placement being offered. Records should be in which details the support provided to service users to promote and maintain their independence. This should enable service users to take control responsibility for aspects of their own lives and daily routines. Systems should be in place to actively promote and support service users to continue with their education or find and maintain employment. This should increase their sense of being of value within the community and promote their self worth. Routines should be in place to make sure that mealtimes are not rushed. Service users should be encouraged to socialise together and to serve themselves and others as they share a mealtime. Because the units are securely managed, systems should be introduced to make sure restriction of movement are not imposed on service users who have capacity and who, after assessment may be able to have unrestricted freedom of movement within the home and the outside community. To make sure service users receive their medication safely and as prescribed, the registered person must arranged for the safe receipt,recording, storage, handling, administering and disposal of medicines at all times. Where service users have capacity, opportunities should be in place to support them after assessment to manage their own medication where possible. Member of staff who have responsibility for medication administration should be trained and competed to carry out their roles and responsibilities. Cleaning routines within the home need improving to make sure all parts of the home are maintained correctly. Where the manager has delegated responsibility to other members of staff for the running of parts of the service, robust monitoring systems should be carried out to make sure he is aware of service standards at all time. To make sure members of staff are aware of current best practice, all polices and procedures should be kept under review. Key inspection report Care homes for adults (18-65 years) Name: Address: Moston Grange Nursing Home 29 High Peak Street Newton Heath Manchester M40 3AJ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sylvia Brown     Date: 1 7 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 21 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 21 Information about the care home Name of care home: Address: Moston Grange Nursing Home 29 High Peak Street Newton Heath Manchester M40 3AJ 01612191300 01612191118 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): EHC Moston Grange Limited Name of registered manager (if applicable) Mr Derek John Stanley Type of registration: Number of places registered: care home 64 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: That the home provides accommodation for service users on four separate nursing units, each accommodating up to 16, with discrete and identifiable staff groups. That the number of persons requiring nursing care by reason of dementia at any one time shall not exceed 64 aged less than 65 years at the time of their referral, except for a variation granted in respect of age for one named individual. When a non - nurse is employed as the manager of the home, a nurse registered on either Part 3 or 13 of the Nursing and Midwifery Council Register is employed as the care to be professionally responsible for the delivery of nursing care. Date of last inspection Brief description of the care home Moston Grange Nursing Home provides accommodation with nursing care for a maximum of 64 adults with dementia. The premises are owned by E.H.C Moston Grange Limited, which is a wholly owned subsidiary of Equilibrium Healthcare Limited. Care Homes for Adults (18-65 years) Page 4 of 21 Over 65 0 64 1 8 1 2 2 0 0 8 Brief description of the care home The home is situated in the North of Manchester City Centre close to main transport routes to and from the city with local shops and amenities within walking distance. The home offers single storey accommodation within bungalow style buildings and all bedrooms are single with en-suite facilities. Off-the-road parking is available for approximately 15 vehicles and gardens were accessible to the people living in the home. Care Homes for Adults (18-65 years) Page 5 of 21 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service would experience adequate quality outcomes. The inspection report is based on information and evidence gathered by the Care Quality Commission (CQC) since the last key inspection, which was completed in December 2008. This was a key inspection which included a site visit to the service. The site visit was unannounced which means the manager and staff were not told that we would be visiting. The inspection was supported by an expert by experience . This is an independent person who has experience of using support services. They spent time meeting with service users and was able to observe their day to day routines as they went about their daily life and receive support. Care Homes for Adults (18-65 years) Page 6 of 21 For reporting purposes the preferred term to be used for people living and receiving a service at Moston Grange is Service users. The report is written on behalf of the Care Quality Commission therefore throughout the report the terms we and us are used As part of the inspection process we gathered information from a number of people which included talking with and seeking the views of service users. Prior to the site visit we also sent out surveys to service users, relatives and members of staff. This gave them an opportunity to tell us about their opinions on the services provided at the home. At the time of writing the report we have not received any comments. At the time of wring the draft report we had not received any comments from service users, relatives or staff and we were awaiting comments from the expert by experience. Any comments received will be shared with the manager and be included within the final report In December 2009 the manager completed a self assessment form, which is called an Annual Quality Assessment Audit(AQAA).This document should tell us in detail what they and the registered provider have done since the last key inspection to meet and maintain the National Minimum Standards. It should also tell us what the manager and the registered provider felt they were doing well, how they had improved within the past 12 months and plans to develop in the next 12 months. The AQAA was completed sufficiently to give us an overview of the service, however to make sure we received all the required information the manager was given a further opportunity to submit additional information. We also gathered information from general contact with the home through their reporting procedures which are called Notifications and information we may have received from other people, such as the general public and professional visitors. We have received one complaint about this service within the previous 12 months, which was appropriately investigated by the manager who resolved the matter without any significant involvement from us. We have also been informed of a number of allegations of abuse at the service. This has not triggered any concerns for us about the service. The manager has improved how he deals with suspicions of abuse and makes appropriate referrals to the Local Authority about all suspicions and allegations if and when they become known to him. All allegations have been independently investigated by the Local Authority under their safeguarding procedures. This report is a public document and should be on display within the home and can be made available for reading upon request. Care Homes for Adults (18-65 years) Page 7 of 21 What the care home does well: What has improved since the last inspection? What they could do better: To make sure that prospective service users have the information they need, service Care Homes for Adults (18-65 years) Page 8 of 21 users guides should be developed for each unit. This would support the service user to make informed decision their future and about the suitability of the accommodation and placement being offered. Records should be in which details the support provided to service users to promote and maintain their independence. This should enable service users to take control responsibility for aspects of their own lives and daily routines. Systems should be in place to actively promote and support service users to continue with their education or find and maintain employment. This should increase their sense of being of value within the community and promote their self worth. Routines should be in place to make sure that mealtimes are not rushed. Service users should be encouraged to socialise together and to serve themselves and others as they share a mealtime. Because the units are securely managed, systems should be introduced to make sure restriction of movement are not imposed on service users who have capacity and who, after assessment may be able to have unrestricted freedom of movement within the home and the outside community. To make sure service users receive their medication safely and as prescribed, the registered person must arranged for the safe receipt,recording, storage, handling, administering and disposal of medicines at all times. Where service users have capacity, opportunities should be in place to support them after assessment to manage their own medication where possible. Member of staff who have responsibility for medication administration should be trained and competed to carry out their roles and responsibilities. Cleaning routines within the home need improving to make sure all parts of the home are maintained correctly. Where the manager has delegated responsibility to other members of staff for the running of parts of the service, robust monitoring systems should be carried out to make sure he is aware of service standards at all time. To make sure members of staff are aware of current best practice, all polices and procedures should be kept under review. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 21 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 21 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: Evidence: The manager of the service has a pre admission procedure in place which includes the assessment of the prospective service users needs and personal requirements before they move in. The AQAA also told us about the pre admission process and stated that the home operates a comprehensive questionnaire which is completed by a member of the management team. During the course of the inspection we looked at two service user files and found that the pre assessment process had been completed for one service user whilst the other, who was admitted as an emergency, had had their needs assessed on the day they moved into the home. The manager stated he makes sure he receives information from placing Local Authorities who have completed their own assessment of the service users needs before any decisions are made about future accommodation. The pre assessment process means service users have the opportunity of meeting Care Homes for Adults (18-65 years) Page 11 of 21 Evidence: someone from the home to ask any questions they may have about the service before they make any decisions about their future. The assessments also enable the registered manager to evaluate if they are able to meet the identified needs and general requirements of the service user before offering them a place at the home. From the assessments we looked were completed by the deputy manager on behalf of the manager of the service. We found the assessments lacked information and mainly consisted of ticked boxs. There was minimal recorded information to enable the home to demonstrate that they had consulted the service user or their representatives about their needs and preferences for care support. There was no recorded evidence to support that the manager of the home had seen the pre assessments and confirmed that the home was able meet the needs of the service user. Service users are made to feel welcome and are able to visit the home to look around before they make any decisions about moving into the home. The manager told us that once a service user makes a decision to be accommodated they can plan their moving in process as they wish. Rooms are prepared in advance with a welcome pack, greetings card and additional information about the home which the service user may find useful. Care Homes for Adults (18-65 years) Page 12 of 21 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: Evidence: Care Homes for Adults (18-65 years) Page 13 of 21 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: Evidence: Care Homes for Adults (18-65 years) Page 14 of 21 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: Evidence: Care Homes for Adults (18-65 years) Page 15 of 21 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: Evidence: Care Homes for Adults (18-65 years) Page 16 of 21 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: Evidence: Care Homes for Adults (18-65 years) Page 17 of 21 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: Evidence: Care Homes for Adults (18-65 years) Page 18 of 21 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 19 of 21 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 20 of 21 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 21 of 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!